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March 24, 2017
Digest

Study Finds Effective Interventions to Prevent Alcohol Use Among Youth

Study Finds Effective

Community-based and individual-level prevention strategies are effective ways to reduce alcohol use among American Indian and other youth living in rural communities, according to a new study supported by NIAAA; NIDA also provided support for the work.

“This important study underscores our commitment to finding evidence-based solutions for alcohol problems in American Indian and other underserved populations,” said NIAAA director Dr. George Koob. “This study is one of the largest alcohol prevention trials ever conducted with an American Indian population and the first to demonstrate the effectiveness of screening and brief counseling intervention in significantly reducing youth alcohol use at a community level.”

Although American Indian teens drink at rates similar to other U.S. teens, they have a higher rate of early onset alcohol use compared to other groups and higher rates of alcohol problems. Rural youths, including those who are a racial minority relative to their community, are also at increased risk for alcohol misuse. Early prevention is critical in these populations, but both American Indians and rural communities have been underrepresented in studies aimed at finding effective solutions for underage drinking.

To address this gap, researchers worked with the Cherokee Nation, the second largest American Indian tribe in the United States, to implement a rigorous research trial of two strategies to reduce underage drinking and its consequences. Communities Mobilizing for Change on Alcohol is a community- organizing intervention designed to reduce alcohol access, use and health and social consequences among underage youths. The second strategy, called CONNECT, is an individually delivered screening and brief intervention presented in schools.

The study was conducted within the 14 counties of northeastern Oklahoma that comprise the Cherokee Nation jurisdictional area, which is home to about 40 percent of the tribe. While Cherokee citizens constitute a significant proportion of the population, whites and other racial/ethnic minorities also live within this area. Results of the trial are reported in the March 2017 issue of the American Journal of Public Health.

“Community organizing has been used effectively in multiple other health intervention trials and appeared to be an optimal strategy to engage diverse citizens in these multicultural communities,” explained research leader Dr. Kelli Komro of the Rollins School of Public Health at Emory University.

Key Step Discovered in DNA Damage from Oxidative Stress

Humans need energy to function and yet a naturally occurring process that generates power for the body can also harm its cells. Cellular mitochondria produce energy, as well as molecules known as reactive oxygen species (ROS). Through a process called oxidative stress, ROS harm cellular DNA by producing frayed ends that cannot be properly fixed during DNA repair processes. The presence of broken DNA will trigger the cell to self-destruct. This is one way the body preserves DNA integrity.

Based on work done by research fellow Dr. Melike Caglayan, a team led by Dr. Sam Wilson reported in Nature Communications how the damage from oxidative stress leads to DNA strand breaks, and ultimately, cell death. Using biochemical and cell biology methods, along with X-ray crystallography, the scientists demonstrated a subtle way that cells can accommodate the damage inflicted by ROS.

The killing power of ROS is important for the process known as innate immunity, or the natural immunity a person is born with. When a bacterium enters the body, a white blood cell activates an immune cell called a macrophage, which douses the bacterium with ROS. Just as ROS causes breaks in human cellular and mitochondrial DNA, it also breaks the bacterium’s DNA, thus killing it. The scheme is a resourceful way to kill living things that could make a person sick, but the ROS response is also triggered when the invaders are particles, such as those in cigarette smoke or smog. In human lung cells, the process may eventually lead to fibrosis, or the thickening or scarring of tissue. Oxidative stress is also linked to chronic lung disease, cataracts, cardiovascular disease and some neurodegenerative disorders. The scientists hope the new findings will lead to better understanding of the origins of these diseases.

Youth with Type 2 Diabetes Develop Complications More Often Than Type 1 Peers

Youth with Type 2 Diabetes Develop Complications More Often Than Type 1 Peers

Teens and young adults with type 2 diabetes develop kidney, nerve and eye diseases—as well as some risk factors for heart disease—more often than their peers with type 1 diabetes in the years shortly after diagnosis. The results are the latest findings of the SEARCH for Diabetes in Youth study, published Feb. 28 in the Journal of the American Medical Association.

Funded by NIH and the Centers for Disease Control and Prevention, SEARCH researchers examined how quickly and often youth developed signs of kidney, nerve and eye diseases, among the most common complications of diabetes. They also measured several risk factors for heart disease. Participants had diabetes an average of under 8 years at the end of the study.

The study is the largest of its kind in the United States. Key findings are:

  • For youth with type 2 diabetes, nearly 20 percent developed a sign of kidney disease by the end of the study, compared to about 6 percent of youth with type 1 diabetes.

  • For youth with type 2, about 18 percent developed nerve disease, versus about 9 percent with type 1.

  • For youth with type 2, about 9 percent developed eye disease, compared to about 6 percent of youth with type 1.

  • Measures for two risk factors for heart disease (hypertension and arterial stiffness) were greater for youth with type 2 but close to equal for a third risk factor (cardiovascular autonomic neuropathy).

  • Though youth with type 2 diabetes showed signs of complications more often in nearly every measure than their peers with type 1, many youth in both groups developed complications.

“There’s often the assumption that young people don’t develop complications from diabetes, but that’s just not true. We saw that young people with diabetes are developing signs of major complications in the prime of their lives,” said Dr. Barbara Linder, a study author and senior advisor for childhood diabetes research at NIDDK. “Particularly for youth with type 2, this research demonstrates the clear need to learn how to reduce or delay the debilitating complications of diabetes, itself a huge challenge for young people to manage.”

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